Top Two Autism Questions

Jacqueline Udell

My beautiful and patient wife reminded me this morning that, although I have spent a great deal of time blogging about this or that, I haven’t really gotten to the meat of the matter. She works with the public, and when clients become aware of what her husband does, they usually ask one or two common questions:

1. What does he think causes autism (with a common variation – is it really an increase)?

2. What does he think about childhood vaccinations (in general, vis-a-vis autism, mercury, their particular kid)?

I’m going to answer the “cause” question first. It’s not as controversial and less complicated to express.

Autism was first reported in 1942; described by a German psychiatrist who said that it was due to a crazy, cold, “refrigerator” mother who did not parent correctly. Now, Dr. Kanner noted G-I problems in almost all of his early patients, yet he still made that spurious conclusion. Could that be because he was a psychiatrist (very fashionable at the time) and when the only tool that you have is a hammer, everything looks like a nail? Gout isn’t due to your lifestyle. Stomach ulcers are due to bacteria, not stress.

And ASD is due to a whole body disorder in which the brain processes in an atypical fashion and G-I health plays an important part. It is 2011, and, unfortunately, there isn’t much more about the disorder that is certain.

Genetic factors play a role as demonstrated by the preponderance of males, incidence in twins, affected siblings and family histories of affected individuals. But, we’re not fruit flies and it takes millions of years for humans to mutate. Admittedly, and as seen in my own practice, there is now inclusion of individuals who (1) have some primary syndrome and ASD is part of that condition and (2) have some other syndrome and ASD is used to assist in service acquisition. But more than 85% of my patients who are ASD patients do NOT have an identifiable syndrome, other than their autism (similar to the literature). The increase is real – you can even ask the skeptical CDC. “Better detection” plays a very minor role in the reported increase. Ask any elementary school teacher over the age of 40.

The environment plays a role. We live in a toxic soup that our current genetic architecture wasn’t necessarily meant to handle. There seems to be no letup to the poisons that are around and within us. I have one patient who definitely improved upon moving from his “chinese drywall” manufactured home. Another male patient made advances after moving from a neighborhood which was adjacent to a power grid. The number of studies that would be required to ascertain how even 10 or 20 chemicals interact is high, the 85,000 (and counting) substances in our modern world – infinite possibilities.

Autoimmunity plays another role. There is a great deal of research which documents inflammation throughout the body of ASD patients. While waiting for solid evidence of a more specific nature, my patients improve greatly by identifying areas of inflammation and addressing those issues. “Immune Thrombocytopenic Purpura” (allergy to your platelets that leads to bleeding) used to be called “Idiopathic Thrombocytopenic Purpura” (I don’t know why your platelets are low but that’s why you are bleeding). Saved the acronym.

Epigenetics is the newest term that is invoked in the genesis of ASD. That is, how the gene, which is on your chromosomes, which codes for a protein, which has an effect upon your cells, interacts with the environment, which has many pollutants (or, at least, we’re not sure how the stuff works) and that interaction is what leads to a state of ill health. So, someone might explain, “Oh, autism is due to epigenetics” and for now, that would be right.

As you can read, it’s too long an answer. It can’t be explained in an elevator ride. So, my personal short-version is, “the epidemic is due to an unlucky combination of susceptible people living in the modern world.” Not too satisfying.

Both questions, by the way, could be answered this way,” My husband says, ‘No one really knows!'”

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